About Anaesthesia

Anaesthesia and You

In the first place, we want to reassure you about the ability and qualifications of the anaesthetist who will manage you during surgery.

Anaesthetists in Australia are specialists – that is, they are among the world’s most highly trained doctors, having spent years undergoing specialist training in anaesthesia, pain control, resuscitation and managing medical emergencies.

  1. The role of the Anaesthetist
  2. What should I tell the Anaesthetist?
  3. Is fasting really necessary?
  4. After the Operation
  5. Complications and risk factors
  6. Going Home
  7. Your Role
  8. What does it cost?
  9. How is the pain managed?

1The role of the Anaesthetist

People often think of anaesthesia as being put to sleep however, that’s not strictly true. Rather, the anaesthetist puts you in a state of carefully controlled unconsciousness. This is done so that surgery will be painless. No chance is taken during this period. All of your bodily functions are carefully and constantly monitored by your anaesthetist.

After your procedure we want you to experience as little pain and discomfort as possible and here again, the anaesthetist will help.

2What should I tell the Anaesthetist?

The anaesthetist wants to have the best possible picture of you and your present conditions so that the most suitable anaesthetic can be planned.

This following information ensures all risks are kept to a minimum, safety and patient care is paramount.

  • How healthy you are, if you have had any recent illnesses and also about any previous operations.
  • Abnormal reactions to any drugs, or whether you have any allergies.
  • Any history of asthma, bronchitis, heart problems or any other medical conditions.
  • Whether you are taking any drugs at present- including cigarettes and alcohol- and, for women, whether they are on the pill.
  • If you have dentures, caps or plates.

3Is fasting really necessary?

We know the pangs of hunger can be severe but no food or drink 4hrs before the operation is a must. Not even water. If you don’t follow this rule, the operation may be postponed in the interests of your safety.

4After the Operation

Your anaesthetist will continue to monitor your condition carefully well after surgery is finished to ensure your recovery is as smooth and trouble free as possible.

Once awake, you will feel drowsy. You may have a sore throat, feel sick or headache. These will soon pass.

To help the recovery process, you will be given oxygen to breathe, encouraged to take deep breaths and to cough. Only when you’re fully awake and comfortable will you be transferred either back to your room, or waiting area before returning home.

Do not worry if there is some dizziness, blurred vision or short term memory loss. It usually passes quite quickly.

5Complications and risk factors

Some, infrequent complications include: bruising, pain or some injury at the site of injections, temporary breathing difficulties, temporary nerve damage, muscle pains, asthmatic reactions, headaches, the possibility of sensation, damage to teeth and dental prostheses, lip and tongue injury, temporary difficulty specking and epileptic seizure.

There can also be some very rare, serious complications including heart attack, stroke, severe allergic or sensitivity reactions, brain damage, kidney or liver failure, lung damage, paraplegia or quadriplegia, permanent nerve or blood vessel damage, eye injury, damage to the larynx (voice box) and vocal cords, pneumonia and infection of the blood transfusion.

Infections
Needles, syringes and intravenous lines are all used only once. They are new in the packet before your surgery commences and they are disposed of immediately afterwards. Cross infection from one patient to another is thus eliminated.

Blood Transfusion
A blood collection today from donors is carefully screened and tested but a very small risk remains. Hence, unless absolutely necessary, blood transfusions are not given.

Remember the possibility of serious complications including death is quite remote but does exist.

We urge you to ask questions. Your anaesthetist Dr Dennis Kerr will be happy to answer them and to discuss the best way to work with you for the best possible outcome.

6Going Home

The best part is that most people now go home much sooner after surgery.

If you are having day surgery, make sure there is someone to accompany you home and for at least 24 hours don’t drive a car, make important decisions, use any dangerous equipment or tools, sign any legal documents or drink alcohol.

7Your Role

There are some things you can do which make your anaesthetic safer:

  • Get a little fitter- even a regular walk will work wonders.
  • Don’t smoke- ideally, give it away six weeks before surgery.
  • Drink less alcohol.
  • Continue to take any medications which have been prescribed but remember to let your anaesthetist and surgeon know.
  • If you are taking aspirin, consult your anaesthetist about whether you should stop taking it two weeks prior to surgery.
  • If you are anxious and have questions make an appointment to see your anaesthetist before admission to hospital and get the answers you need.
  • If you have any kind of health problem tell your anaesthetist and surgeon so they are fully informed.

8What does it cost?

You should be aware that Medicare and Medical Fund rebates generally do not cover the entire costs of your anaesthesia. In other words, there will usually be a gap which you will be expected to pay. If you have any questions about costs please talk with your anaesthetist.

9How is the pain managed?

The fear of pain can interfere with a satisfactory recovery, and can interfere with a rapid return to normal function. Accordingly, a large part of the preoperative preparation revolves around an understanding of how we are going to manage the pain, and focusing on a rapid return to an active life.

The Joint Orthopaedic Centre have developed a multimodal technique for the control of pain following knee and hip surgery, called The Kohan-Kerr “Local Infiltration Analgesia Technique” (LIA).  The aim here is to try and minimise the impact of the operation on the patient’s life.  Rather than ‘drugging’ the whole patient we concentrate on the localised area.

The Local Infiltration Analgesia Technique is based on systematic infiltration of a mixture of ropivacaine, ketorolac, and adrenaline into the tissues around the surgical field to achieve satisfactory pain control with little physiological disturbance.

The technique allows virtually immediate mobilization and earlier discharge from hospital.

In order to minimise the pain, we adopt three pathways.

1. The first pathway, involves the establishment of an effective local anaesthetic block at the time of the operation. (The LIA Kohan-Kerr Technique) In essence, we try and numb all the parts which have been operated on and which may generate pain. After the operation the area involved usually feels numb. This is a feeling similar to that experienced at the dentist when a local anaesthetic injection is given.

2. The second pathway involves oral medications. These are prescribed to try and improve the pain control. Injections are also available if required.

3. Postoperatively, a pain controlling skin patch may be applied, which also contains a slow release analgesic.

We have found this process to be extremely effective at controlling pain. We cannot say that you will have no pain, but rather, that manageable discomfort will be present. We aim for the discomfort not to reach a level, which would interfere with your ability to mobilise effectively.